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De l'épidémiologie de santé publique à l'épidémiologie clinique : Quelques réflexions sur la relation entre épidémiologie et clinique (1920-1980)

Abstract : During the first half of the 20th century, the discipline of epidemiology was demarcated in terms of its differences with clinical medicine. As a public health discipline, its level of analysis was the population rather than the individual, and the vital statistics and demographical data were its main objects of analysis. During the fifties, however, a significant shift occurred. Some specific methods of etiological studies (cohort study and case-control study) on groups of individuals were further developed and a number of statistical tools derived from the new inferential statistics began to be used and adapted to the analysis of epidemiological data. Since the 1960-1970s, the identification of individual risk factors based on etiologic studies has led to the development of an individualized prevention of disease risk. Thus, the individual appears to be at the forefront of this new epidemiology and the preventive strategies. But should we consider that we are witnessing a clinical turn in epidemiology? The goal of this paper is to study aspects of the convergence between epidemiology and clinical medicine in analyzing one of the paradigmatic cohort studies of the nascent modern epidemiology, the Framingham Heart Study. Led since 1947-1948 in Framingham, this pioneering cohort study on cardiovascular disease shaped the development and diffusion of the notion of risk factor. I will argue that this study and more generally cardiovascular epidemiology as developed in the United States have their origins in both approaches and questions that pertain to clinical medicine. I will then assess whether, and if so, to what extent, a historical and methodological link can be established between the new connection between epidemiology and clinical medicine that emerges from risk factor epidemiology and what is now called "clinical epidemiology".
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Contributor : Élodie Giroux <>
Submitted on : Thursday, April 23, 2020 - 10:08:13 PM
Last modification on : Monday, October 19, 2020 - 11:09:10 AM

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Élodie Giroux. De l'épidémiologie de santé publique à l'épidémiologie clinique : Quelques réflexions sur la relation entre épidémiologie et clinique (1920-1980). Bulletin d’histoire et d’épistémologie des sciences de la vie , Editions Kimé, 2012, 19 (1), pp.21-43. ⟨10.3917/bhesv.191.0021⟩. ⟨halshs-00853931⟩

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